25 years old Lady with h/o few drops bleeding after defecation and an external swelling for 1 month but mild Pain , came to surgery opd. She also has a h/o constipation . Now she is taking Lactulose and isopagul and constipation is under control. But She complaints that swelling is increasing day by day.

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External Hemorrhoides Infected fissure in Ano Anal fistula infected are differential diagnosis For constipation Stool softener like lactulose syrup or cremation citrate Warm water with added salt air Bath becomes salinity water will reduce yeast infection Any antibiotic both tropical and oral is advisable

She is having anal fissure and now developing sentinel tag. If very much symptomatic than it has to be excised. Rule out hemorrhoids

Hemorrhoides(External). Control of Constipation, Seitz Bath, Oral Tranexamic acid, Lifestyle modification

Ohhh... Oral Lactose/polyethylene glycol l, Topical Shield oint, before and after evacuation.
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D/d 1 fissure ano 2 perianal abscess if pr /ps is possible do it and find out what rectum looks like and rule out piles and proctitis.

Thanx dr Mohd Adil
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Fissure in ano with external sentinel pile. Should respond to conservative approach. LAS if resistant recurring.

Anal fissure

Sir, as I have seen fissure and also external hemorrhoids is very painful but in this case patient first told about bleeding but after asking further she stated very little pain. Is it possible?

It is possible that fissure in ano present with mild symptoms Constipation history supports fissure and location is also posterior midline
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This is anal fissure with tag,requre stoolsoftner ,topical shield oint.high fiber diet.nsaid fer pain

External hemorrhoid with anal fissure

Haemorroids - External.

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